ESTIMATION OF RISK FACTORS OF EARLY POSTOPERATIVE MORTALITY IN ELDERLY PATIENTS WHO ARE SUBJECTED TO GASTRIC SURGICAL PROCEDURES

I. Pešić, M. Nestorović, V. Pecić, M. Radojković, Lidija Đorđević, Miodrag Đorđević, Toplica Bojić
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Abstract

The use of screening programms in elderly population (age ≥65 years) comprises an increasing proportion of patients undergoing emergency general surgery (EGS) procedures nowadays. The aim was to determine the intra-hospital mortality rate in elderly patients undergoing gastric surgical procedures. 108 elderly patients (≥65 years old) were examined, divided into two groups: deceased and surviving surgical patients, treated for diseases (benign and malignant) of the stomach. The patients were divided into four age groups and five ASA groups, taking into account the presence of chronic diseases, the values of some laboratory parameters, administered transfusion and the occurrence of surgical complications during hospitalization. The mortality rate among elderly patients was 28.7%. The significant risk factors for mortality were: emergency surgery (p < 0.001), bleeding gastric ulcer operations (p = 0.042), lung (p = 0.003), kidney (p < 0.001), heart (p = 0.025) diseases, ASA score of 4 or higher (p < 0.001), serum levels (higher after two times measurement) of creatinine, haemoglobin, CRP, PCT and glycemia (p < 0.001). In order to improve medical treatment, the determination of independent validated risk indicators for mortality in elderly patients might lead to developing a dedicated scoring system.
老年胃外科手术患者术后早期死亡率的危险因素评估
如今,在接受急诊普通外科手术(EGS)的患者中,老年人(≥65岁)使用筛查方案的比例越来越大。目的是确定接受胃外科手术的老年患者的院内死亡率。对108例≥65岁的老年患者进行检查,分为两组:已死亡和幸存的手术患者,治疗的胃疾病(良性和恶性)。将患者分为4个年龄组和5个ASA组,考虑慢性疾病的存在、一些实验室参数的值、是否输血和住院期间手术并发症的发生。老年患者死亡率为28.7%。死亡的显著危险因素为:急诊手术(p < 0.001)、胃溃疡手术出血(p = 0.042)、肺部(p = 0.003)、肾脏(p < 0.001)、心脏(p = 0.025)疾病、ASA评分4分及以上(p < 0.001)、血清肌酐、血红蛋白、CRP、PCT和血糖水平(两次测量后升高)(p < 0.001)。为了提高医疗质量,确定独立有效的老年患者死亡率风险指标可能会导致开发一个专门的评分系统。
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